Successful treatment of hemorrhagic chronic radiation proctopathy with a novel self-assembling peptide

Aims Chronic radiation proctopathy is common manifestation of the epithelial damage to the rectum caused by radiation therapy. Despite its uncertain long-term efficacy and side effects occurring in up to 20% of patients, because of the lack of effective topical agents argon plasma coagulation of teleangiectasias is currently treatment of choice [1].

Here we present case of a patient with hemorrhagic chronic radiation proctopathy successfully treated with a novel self-assembling peptide.

Methods A 75-year-old patient was referred to our Centre for spontaneous rectal bleeding and debilitating pain four months following radiation therapy for prostate cancer.

A lower endoscopy was performed revealing 30 mm large rectal ulcer with surrounding teleangiectasias. We decided to try treatment with novel self-assembling peptide gel Purastat (3D-Matrix Europe Ltd., France). Gel was applied through catheter covering the whole surface of ulcer and surrounding mucosa with teleangiectasias. Patient underwent 4 sessions of therapy (weeks 0 – 3 mL (Fig. 1), 3 – 4 mL (Fig. 2), 6 – 1 mL (Fig. 3), 12 – 1 mL (Fig. 4)).

Results On each subsequent endoscopy there was obvious regression of endoscopic finding as well as significant improvement in patient’s symptoms. On week 12 patient was symptom free and there was no ulceration left and we applied 1 mL of Purastat on small persisting teleangiectasias. On week 24 (Fig. 5) rectoscopy revealed complete mucosal healing.

Conclusions A novel self-assembling peptide as a topical agent without known side effects might present a promising tool in treating patients with hemorrhagic chronic radiation proctopathy.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• 1 Zhong QH, Liu ZZ, Yuan ZX. et al. Efficacy and complications of argon plasma coagulation for hemorrhagic chronic radiation proctitis. World J Gastroenterol 2019; 25 (13) 1618-1627

Publication History

Article published online:
14 April 2023